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The Allied Health Professions Advisory Fitness for Work Report and how to complete it

Allied Health Professional (AHP) Health and Work Report

5. Example condition: Traumatic brain injury

Melody Bose has had a Traumatic Brain Injury. She is being discharged home after two months on a rehab unit. She is a full time secondary school teacher. She lacks full insight into her condition and overestimates her abilities. She is keen to return to work and regain a sense of normality, and misses her colleagues. She has cognitive deficits, is emotionally labile – which affects her concentration and communication, and experiences physical and cognitive fatigue (affecting memory of recent events and concentration) after 30 minutes.

She has some right lower limb weakness and struggles with walking for longer than 10 minutes, and climbing stairs. She is mobilising with two sticks. She is at increased risk of epilepsy for 6-12 months. She is adhering to epilepsy precautions of no driving and working at heights and has informed the DVLA. She is learning strategies to manage her cognitive deficits, and is receiving Cognitive Behaviour Therapy for her mood every week over the next two months.

She will continue to attend the unit on a weekly basis to progress her rehabilitation. She is not yet fit for work. You are going to review her work ability again on 17th March but she is unlikely to be fit for any work before then. Currently her prognosis is unclear, but even after her return to work she is likely to have further treatment. You think she would eventually benefit from a workplace assessment, which you are able to offer, and/or that she is referred to occupational health.

Would you like to have a go? - Please fill in the AHP Report.

Click on the Example information button button to get some help

Allied Health Professions
Advisory Fitness for Work Report

1 Patient's name: Melody Bose
Date of birth: 13/06/1972

I advise that:


2 This form has been completed by a:
Physiotherapist / Occupational Therapist / Podiatrist / Other

Practitioner's name: Your Name
HCPC registration number: OT XXXXX
Organisation/Service: Name of your service / department / unit
Contact details (email/ tel no.): Your contact info
4 AHP Advisory Fitness for Work Report issued for period from to
A follow up review / required* has been made for *delete as appropriate

5 With your employer's agreement you may benefit from these or more options:

Examples of phased returns
Workplace assessments

6 Patient-reported work-relevant difficulty, recommendations and goals:

Difficulty Functional limitations Recommendations / goals Examples of workplace adaptations

7 Comments Other helpful information or actions Other helpful information or actions Duration and fluctuation

8 Additional information is provided on 0 accompanying sheets
9 Signature: Your signature

AHPs: please follow the guidance held on the website of your professional body when filling out this form and always attach the information sheet for employees, employers and doctors. Employees, employers and doctors: please read information attached or log on to:

This report does not replace the Statement of Fitness for Work (fit note) for benefits purposes.

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